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— 1 <br /> PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320U CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-3810- FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �a •-a.'� -I Z <br /> SITE ADDRESS P.4RCEL TAX I.D.# PERMIT p <br /> 4729 BAYVIEW LN o04��00040030o rLt I 21'Z ' G�j� <br /> LEGAL LOTNO. BLOCK TRACT <br /> DESC <br /> OWNER ADDRESS QN/ZIP PMONE <br /> SWAN 4729 BAYVIEW LN Everett98203 805-459-4673 <br /> TENANT NAME CONTACT FOR PERMIT PNONE <br /> IJennifer Burgess 206-774-9499 <br /> CONTRACTOR 1A/ESCO ADDRESS pTV21P PHONE <br /> VV 3909 196 St SW� Lynnwood 9d036 $00-398-4663 <br /> CONTR.LICENSE q,^,^�H�ES 97�Op <br /> VV/1 U <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> COMMERCIAL _e�e�c�i� �c,�s_ocna� $3425.10 <br /> WORI( DESCRIPTION <br /> GAS TO GAS TANKLESS WATER HEATER WITH 40' GAS PIPING <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM NO. TVPE OF FI%TURE OR ITEM <br /> _ Toilet A/C —air handling units <br /> _ Bathtub Forced air systems <br /> _ lavatory (v�sh basln) � Gas piping <br /> Shower � Water heater <br /> _ KRchen sinh E tlisposat Gas hreplace <br /> __ Dishwasher Gas ranga <br /> __ Cbthes washer Clothes dryer <br /> _ Laundry Iray Range hood <br /> _ Smh (sernce/bar/mop/etc ) Exhaustfan <br /> 0ackflow preventer Heat pump <br /> _ Unnal UnR heater <br /> Dnnking Fountain BOiler <br /> _ Floor drain Refngera6on <br /> Giease trap Woodstwe <br /> Root drams Other <br /> Othef <br /> CIT/OF EVERETT LOCAL SALES TA%CODE IS J105 <br /> I heieby cennty that I have read antl exammed this application and hnow the same to be true antl correct All prwisions of laws antl <br /> orhinaces goveming ih�s type cf work will be complietl with vihether specihetl herein or not The granting of a permit tloes not presume <br /> Io grve authonty to vwlate or cantel ihe provision of any other state or lo[al law regulatmg mnstruclion ur ihe pertormante of <br /> construchon 1 hat I am authon_etl by Ihe ovmer of this property to perlorm the work for whKh application is matle and I comply with the <br /> 5!ate Contractors Law 18 27 RCW and 296 200 WAC <br /> ��.�.p:�M1 a Jn�v i�r u.,rnn Mmqn� <br /> _lennifer Bur ess �„ ,. ,�,,,.��,,,,,,� , ,,.,,,�,,,,�,.,, .�.,.,�,,,r,,,� <br /> I I 1w91 nn.nl�P.n,Jnnn,�,��.�mi�.c;m nu1 <br /> Sigiiatura of Owner/Contracto Authon�atl n - -� � � � ate <br />